NPI | 1508103029 |
---|---|
Entity Type | Organization |
Authorized Contact | TERRY L HOYT Owner 479-784-0011 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-2638) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 2789) |
Enumeration Date | 2013-01-04 |
Last Update Date | 2013-05-14 |